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WO2017198472A1 - Fil multipolaire double implantable dans le réseau coronarien veineux - Google Patents

Fil multipolaire double implantable dans le réseau coronarien veineux Download PDF

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Publication number
WO2017198472A1
WO2017198472A1 PCT/EP2017/060661 EP2017060661W WO2017198472A1 WO 2017198472 A1 WO2017198472 A1 WO 2017198472A1 EP 2017060661 W EP2017060661 W EP 2017060661W WO 2017198472 A1 WO2017198472 A1 WO 2017198472A1
Authority
WO
WIPO (PCT)
Prior art keywords
lead
branch
lead body
branches
bifurcation
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Ceased
Application number
PCT/EP2017/060661
Other languages
English (en)
Inventor
Jean-François Ollivier
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Sorin CRM SAS
Original Assignee
Sorin CRM SAS
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Sorin CRM SAS filed Critical Sorin CRM SAS
Priority to EP17720170.4A priority Critical patent/EP3458148B1/fr
Priority to US16/302,051 priority patent/US10912938B2/en
Publication of WO2017198472A1 publication Critical patent/WO2017198472A1/fr
Anticipated expiration legal-status Critical
Priority to US17/170,424 priority patent/US12042650B2/en
Ceased legal-status Critical Current

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00—Electrotherapy; Circuits therefor
    • A61N1/02—Details
    • A61N1/04—Electrodes
    • A61N1/05—Electrodes for implantation or insertion into the body, e.g. heart electrode
    • A61N1/056—Transvascular endocardial electrode systems
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00—Electrotherapy; Circuits therefor
    • A61N1/02—Details
    • A61N1/04—Electrodes
    • A61N1/05—Electrodes for implantation or insertion into the body, e.g. heart electrode
    • A61N1/056—Transvascular endocardial electrode systems
    • A61N1/0563—Transvascular endocardial electrode systems specially adapted for defibrillation or cardioversion
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M25/00—Catheters; Hollow probes
    • A61M25/01—Introducing, guiding, advancing, emplacing or holding catheters
    • A61M25/09—Guide wires
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00—Electrotherapy; Circuits therefor
    • A61N1/02—Details
    • A61N1/04—Electrodes
    • A61N1/05—Electrodes for implantation or insertion into the body, e.g. heart electrode
    • A61N1/056—Transvascular endocardial electrode systems
    • A61N1/0565—Electrode heads
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00—Electrotherapy; Circuits therefor
    • A61N1/18—Applying electric currents by contact electrodes
    • A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
    • A61N1/38—Applying electric currents by contact electrodes alternating or intermittent currents for producing shock effects
    • A61N1/39—Heart defibrillators
    • A61N1/3918—Heart defibrillators characterised by shock pathway, e.g. by electrode configuration
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00—Electrotherapy; Circuits therefor
    • A61N1/02—Details
    • A61N1/04—Electrodes
    • A61N1/05—Electrodes for implantation or insertion into the body, e.g. heart electrode
    • A61N1/056—Transvascular endocardial electrode systems
    • A61N2001/0585—Coronary sinus electrodes

Definitions

  • the invention relates to "active implantable medical devices" as defined by the Directive 90/385 / EEC of 20 June 1990 of the Council of the European Communities, more precisely implants for continuously monitoring the heart rate and delivering, if necessary, to the heart Electrical pulses for stimulation, resynchronization and / or defibrillation in the event of a rhythm disorder detected by the device.
  • It relates more specifically to detection/stimulation endovascular cardiac leads intended to be implanted in the coronary artery of the heart to allow the stimulation of a left, ventricle or atrium, cavity and/or the detection of depolarization potentials at these cavities.
  • placing permanent leads in a left heart cavity would involve significant operational risks, for example the risk of bubbles to the cerebral vascular network located downstream of the left ventricle.
  • a lead not into the cavity to be stimulated but into the coronary artery, the lead being provided with an electrode which is applied against the cavity wall of the epicardium and directed towards the left ventricle or the left atrium, as the case may be.
  • These leads stimulate the cardiac muscle via one or more point electrodes whose position is a function of the predefined trajectory of the cannulated vein.
  • a lead of this type is, for example, the Situs LV model, marketed by Sorin CRM (Clamart, France) and described in EP 0 993 840 A1 (ELA Medical).
  • multiple multipoint stimulation (MPP) of the left ventricle has many advantages, and this approach is made possible by the availability of multipolar left ventricular leads, which allow for wider triggering of cardiac cells, leading in particular to better contractility.
  • the distance between the stimulation points is relatively small, especially since the most distal electrode is often unusable because of undesirable phrenic stimulation (stimulation occurring due to the apical positioning of the most distal electrode).
  • the useful distance between the two stimulation points of a single-body lead is less than 30 mm, for typical curvilinear lengths of the left ventricle of the order of 80 mm in the mitral valve/apex axis and 70 mm for the basal circumference.
  • a first proposal consists in implanting two standard ventricular leads of the standard type, these leads being coupled proximally by means of a standardized Y-adapter IS-1 or IS-4, or at the level of the pulse generator by means of a housing head adapted to receive separately the respective connectors of the two left ventricular leads.
  • Another proposal consists in implementing not endovascular leads but epicardial leads, implanted surgically or mini-surgically.
  • this technique is very rarely used because it is too invasive for a benefit that is still uncertain.
  • US 2002/143380 A1 (US Pat. No. 6,772,015 B2) proposes to produce a single endovascular lead comprising a lead body equipped with a defibrillation coil and having, upstream of the coil, a branch from which a lateral extension intended to penetrate into a secondary vessel extends.
  • the resulting configuration is that of a bifurcation between a "finger portion” (the elongated main lead body extending beyond the bifurcation) and a "thumb portion” (the short side branch).
  • the insertion of this lead is effected by prior insertion of the two parts together in a catheter of suitable diameter.
  • the catheter is then advanced into the main vein of the coronary artery up to the level of the secondary vessel.
  • the lead is then pushed out of the catheter so that the finger portion advances in the main vein and then, as the thumb portion reaches the outlet of the catheter, that thumb portion is directed toward the secondary vessel to be progressively introduced therein at the same time that the finger portion finishes its progression in the main vein.
  • the catheter is finally removed when the lead with its two branches reaches its definitive final position.
  • this thumb portion is of very short length, and provides only a very punctual stimulation, which is also confined to the region near the outlet of the secondary vessel in the main vein.
  • the use of a catheter with a relatively large diameter precludes the possibility of intervention in deep regions of the coronary venous network, which are yet the most favorable regions in terms of effectiveness of stimulation of the left cavities of the heart.
  • EP 2,559,453 A1 and EP 2 572 751 A1 (Sorin CRM), which consists in introducing the distal part of the lead down a first vein ("outward” vein) and then by an anastomosis towards a second vein (“return” vein) by going back up into it.
  • first vein outward
  • second vein return
  • the presence of distal anastomoses in the coronary venous network has been observed in a large proportion of patients, i.e. at the end of some veins there is a passage to another vein, which makes possible communication between two distinct veins at the level of the anastomosis, via their respective distal ends.
  • the distribution of the electrodes on the lead may be chosen such that these electrodes are grouped into two separate sets forming two distinct active parts, one intended to stimulate in the outward vein and the other in the return vein. These two groups of electrodes are separated by an electrode-free region corresponding to the most distal part of the outward vein, the region of the anastomosis and to the most distal part of the return vein.
  • the object of the present invention is to propose a novel bifurcated endovascular lead configuration, i.e. a single lead having two branches in its distal part, which overcomes the disadvantages of the leads proposed up to now, by providing the following benefits:
  • the lead using only conventional techniques very well mastered by the practitioners, and standard implantation accessories (guidewire, guide-catheter, sub-selection catheter, etc.);
  • the invention provides a multipolar detection/stimulation endovascular lead comprising, in a manner known per se: a lead body; in the proximal part of the lead body, a connector for connection to a cardiac pacemaker/defibrillator generator; and in the distal part of the lead body, an active portion extending the lead body beyond a bifurcation of the lead body from which a first branch and a second branch extend.
  • the proximal ends of the first and second branches are joined at the bifurcation and the distal ends of the first and second branchs are free ends and each of the first and second branches carries an array of electrodes connected to the connector.
  • each of the first and second branches comprises a distal guide element presenting at the free end of the branch an outlet in the distal direction, this outlet being capable of receiving an implantation guide wire inserted therein and guiding this implantation guide wire in an axial direction parallel to the main axis of the lead body.
  • the distal guiding element of the first and/or the second branch is formed by a hollow sheath forming a body of the branch and traversed right through by a central lumen extending from the outlet at the free end of the branch to an outlet at the opposite proximal end situated in the vicinity of the bifurcation, the central lumen being adapted to receive the implantation guide wire inserted therein and the opening at the opposite proximal end being capable of guiding this implantation guide wire in an axial direction parallel to the main axis of the lead body and radially at a distance from the lead body;
  • the distal guiding element of the first and/or the second branch is a hollow guiding nacelle mounted in the vicinity of the free end of the branch, this hollow guiding nacelle being able to receive the implantation guide wire introduced therein and guiding this implantation guide wire in an axial direction parallel to the main axis of the lead body and radially away from the lead body;
  • the lead body is formed by a hollow sleeve through which a central lumen passes,
  • One of the branches then being advantageously formed by an axial extension of the lead body, the distal guiding element of the branch being formed by a hollow sheath through which a central lumen communicating with and extending the central lumen of the lead body at the bifurcation passes, the lumens of the lead body and of the branch being adapted together to receive the implantation guide wire inserted therein;
  • the lead body is formed by a microcable extending from the connector at the bifurcation and carrying at the bifurcation a supporting and connecting element of the first and second branches;
  • the first and/or the second branch is formed by a microcable extending from the bifurcation at the free end of the branch, the lead body carrying at the level of the bifurcation a supporting and connecting element of the first and/or second branch;
  • the respective electrode arrays of the first and second branches are electrically distinct arrays separately connected to respective poles of the connector by a common multipolar conductive arrangement of the lead body.
  • Figure 1 generally illustrates the myocardium, with the main veins of the coronary artery network in which a lead according to the invention has been implanted, intended for stimulation of the left ventricle.
  • Figure 2 is an overall view of the lead according to the invention, showing the various elements which constitute it and the guide wire used for its implantation.
  • FIGS. 3a and 3b are detailed views, in section, of the lead of the invention at the level of the branch, respectively, without and with the insertion guide wire inserted in the lumens of the two branches of the lead.
  • Figures 4 to 7 illustrate lead configurations corresponding to various embodiments of the invention.
  • Figure 1 generally illustrates the myocardium and the main vessels of the coronary artery network, in which a lead 100 has been introduced in order to stimulate the left ventricle.
  • This lead 100 is endocardially implanted into the coronary venous network via the superior vena cava, the right atrium and the CS entrance of the venous coronary sinus.
  • the coronary venous network then develops in several branches from the large coronary vein GVC, these branches comprising the posterolateral VPL, lateral VL, anterolateral VA and posterior VP veins.
  • Figure 2 illustrates more precisely the various constituent elements of the endovascular lead 100 of the invention, implanted in the coronary artery as illustrated in Figure 1 .
  • This lead 100 comprises a lead body formed, in the illustrated example, of a flexible hollow sheath with an internal lumen.
  • This lead body has a bifurcation 1 12 on the distal side and a connector 120 for connection to the connector head of a pacing pulse generator, for example IS-4 standard connector.
  • the first branch 130 is constituted by a hollow sheath with an internal lumen which extends axially the lead body 1 10 on the proximal side.
  • the distal end 134 of the branch 130 is a free end with a through opening, preferably provided with a shutter allowing only the sealing passage of a tip 210 of a loop 220 of a guide-wire 200 for the implantation procedure which will be described below.
  • the branch 130 is also provided with one or more electrodes, with in the illustrated example two electrodes 136, 136' connected respectively to two distinct poles of the connector 120 via connection conductors which will be described in more detail with reference In Figure 3a.
  • the second branch 140 is connected at its proximal end 142 to the bifurcation 1 12 of the lead body and extends in a direction generally parallel to the lead body 1 10 and to the first branch 130 in the vicinity of the branch 130 at a substantially constant distance from the latter.
  • the branch 140 is formed of a hollow sheath with an internal lumen opening out on the side of the proximal end 142 as well as on the side of the distal end 144, preferably with a shutter allowing only the passage of a return end 230 of the loop 220 of the guide wire 200 used for the implantation procedure.
  • the branch 140 is provided with one or more electrodes, in the example illustrated, two electrodes 146, 146', connected to separate poles of the connector 120.
  • the connector 120 may in particular be a standardized quadripolar IS-4 connector, the respective poles of which are connected to the four electrodes 136, 136', 146 and 146'.
  • the typical length of the branches 130, 140 is of the order of 30 to 100 mm, the branches being of different lengths.
  • branches 130 and 140 may be preformed, for example bent in a distal part, to ensure better retention in the vascular network and/or better contact of the electrodes with the tissues, according to techniques known per se.
  • the electrode 136 (and/or 136'), and likewise the electrode 146 (and/or the electrode 146'), may consist of an isopotential electrode doublet, the two electrodes of the doublet being situated on the same branch, or on either branch.
  • the configuration of the various elements of the lead 100 allows the introduction into each of the two branches of a single implantation guide wire 200 with a first portion or end portion 210 extending inside the lead body 1 10 and of the first branch 130, opening at the end 134 of this branch 130, in order to form a loop 220 continuing in a second part or return end 230 which penetrates into the distal end 144 of the second branch 140, to the proximal end 142 from which it opens outwardly.
  • the guide wire 200 is thus presented to the practitioner in its most proximal part with two ends 212, 232.
  • the part corresponding to the end 212 (the end piece 210) passes axially through the connector 120 and the lead body 1 10, while the part corresponding to the end 232 (return end 230) joins the second branch 140.
  • Figures 3a and 3b are detailed views in section at the bifurcation 1 12, respectively, without and with the forward end 210 and the return end 230 of the guide wire 200 inserted in the branches 130, 140.
  • the two proximal ends 132, 142 of the branches 130, 140 are joined at the bifurcation 1 12, so that the internal lumens and hollow sheaths forming the two branches 130, 140 extend along substantially parallel directions ⁇ 1 and ⁇ 2 between them and with a spacing d in the transverse direction.
  • the two sheaths of the branches 130, 140 are joined together at the bifurcation 1 12 by a flexible bridge 1 14.
  • the distal end 142 of the branch 140 opens out in the distal direction so as to allow passage of the return end 230 of the guide wire 200, as illustrated in Figure 3b.
  • the two branches 130, 140 thus ensure the guiding and the parallelism of the two ends of the guide wire once these two ends have been introduced into the internal lumens of the branches wherein they are guided.
  • the independent electrodes 136, 136' of the branch 130 are connected to respective insulated wires 138, 138', and likewise the independent electrodes 146, 146' of the branch 140 are connected to respective insulated wires 148, 148'.
  • These insulated wires are wound inside each of the branches 130, 140 so as to leave the central lumen free to allow insertion of the guide wire ends 210, 230.
  • the respective wire groups 138, 138' and 148, 148' are then gathered at bifurcation 1 12 into a bundle of four wires 136, 136', 146, 146' wound along the length of the lead body to the connector 120, the four poles of which are connected to each of the respective conductors.
  • the implantation of the lead of the invention is carried out by the following steps (all of which implement conventional techniques, very well mastered by the practitioners):
  • the design of the lead according to the invention makes it possible to use an additional accessory making it possible to increase very substantially the "pushability" (the progression ability of the lead in the venous network by an action exerted from the proximal end accessible to the practitioner).
  • Figures 4 to 7 illustrate lead configurations corresponding to various embodiments of the invention.
  • Figure 4 illustrates the configuration described above with reference to Figures 2, 3a and 3b, wherein the lead body 1 10, the first branch 130 and the second branch 140 are all made in the form of a hollow sheath with a central lumen .
  • the first branch 130 extends in the extension of the lead body 1 10, while the second branch 140 is a lateral branch extending parallel to the branch 130 and connected to the outer surface of the sheath of the lead body 1 10 at the bifurcation 1 12.
  • Figure 5 illustrates a variant wherein the lead body consists of a multipolar microcable 150, hence without central lumen.
  • the two branches 130, 140 extend parallel to one another and are connected to the distal end of the microcable 140 by the bifurcation 1 12, the two branches 130, 140 having a structure comparable to that described for the branch 140 of the embodiment of Figures 2 to 4.
  • a microcable consists of an assembly, for example a strand of several cables of very small diameter, each comprising an electrically conductive core provided with an insulating coating.
  • microcable may in particular be that described in EP 2 455 131 A1 and EP 2 581 107 A1 (Sorin CRM), to which reference may be made for further details.
  • this embodiment of the lead makes it possible to use one or two additional accessories making it possible to increase very substantially the "pushability", that is to say the progression ability of the lead in the venous network by an action exerted from the proximal end accessible to the practitioner.
  • FIG. 6 illustrates another embodiment of the invention wherein the lead body 1 10 and the first branch 130 have the same configuration as in the embodiment of Figures. 2 to 4, that is to say they consist of a hollow sheath with the branch 130 in the extension of the lead body 1 10.
  • the second branch 140 is made in the form of a monopolar or multipolar microcable 160.
  • a guiding element 170 is provided at the distal end of the branch 140 in the form of a Rapid Exchange type ring or nacelle enabling this branch 140 (i.e. the microcable 160) to be guided to the selected target vein.
  • the microcable 160 may advantageously consist of a conductive core provided with an insulating coating, with the exception of punctually exposed areas used to constitute the detection/stimulation electrodes 146, 146'.
  • the very small diameter of the microcable 160 makes it possible in particular to exploit the entire length of the vein and cannulate vessels of very small diameter, which makes it possible to operate in new regions that are difficult to reach and thus to optimally use all the veins present in the basal zone, in particular to avoid the risk of phrenic stimulation, which generally increases when the lead is too distal.
  • the implantation method is as follows:
  • Figure 7 illustrates yet another embodiment of the lead of the invention, wherein one and the other branch 130, 140 are each constituted by a microcable, respectively, 160 or 180, like the microcable 160 of the embodiment of Figure6.
  • Each of the microcables 160, 180 is provided with a respective guiding element in the form of a nacelle 170, 190 to guide the return end 230 and the guide wire end 210 respectively.
  • the method of implantation is then as follows:
  • Still another variant consists in providing one of the branches of a defibrillation coil for the possible application to the myocardium of a high energy shock at a left cavity.
  • a further alternative embodiment consists in providing a lead body 1 10 in the form of a tubular sheath, the diameter of the internal lumen of which makes it possible to accommodate the two forward 210 and return 230 ends of the guide wire 200 or a lead body comprising two distinct internal lumens, for the same purpose. This makes it possible to optimize the trajectories of the two ends of the guidewire and the good sliding of the lead on the guidewire while avoiding potential kinks of the two ends of the guidewire.
  • Still another improvement is to provide the distal ends of the two branches 130, 140 with a mechanical connection system, for example of the male cone / female cone type or a bayonet system, making it possible to make a loop formed by these two branches in the venous network.
  • a mechanical connection system for example of the male cone / female cone type or a bayonet system

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  • Health & Medical Sciences (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Engineering & Computer Science (AREA)
  • General Health & Medical Sciences (AREA)
  • Biomedical Technology (AREA)
  • Veterinary Medicine (AREA)
  • Cardiology (AREA)
  • Public Health (AREA)
  • Animal Behavior & Ethology (AREA)
  • Radiology & Medical Imaging (AREA)
  • Vascular Medicine (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Biophysics (AREA)
  • Pulmonology (AREA)
  • Anesthesiology (AREA)
  • Hematology (AREA)
  • Electrotherapy Devices (AREA)

Abstract

Le fil (100) comprend un corps de fil (110) présentant une partie proximale (120) un connecteur vers un générateur de stimulateur/défibrillateur cardiaque, et dans une partie distale une première ramification (130) et une seconde ramification (140) s'étendant au-delà d'une bifurcation (112). Les extrémités distales (134, 144) des ramifications sont des extrémités libres portant une rangée d'électrodes (136, 136', 146, 146') connectées au connecteur (120). Chacune des ramifications comprend à son extrémité libre un orifice de sortie dans le sens distal, capable de recevoir un fil guide d'implantation (210, 230) inséré à l'intérieur et pour guider ce fil guide d'implantation dans un sens axial parallèle à l'axe principal du corps de fil.
PCT/EP2017/060661 2016-05-19 2017-05-04 Fil multipolaire double implantable dans le réseau coronarien veineux Ceased WO2017198472A1 (fr)

Priority Applications (3)

Application Number Priority Date Filing Date Title
EP17720170.4A EP3458148B1 (fr) 2016-05-19 2017-05-04 Fil multipolaire double implantable dans le réseau coronarien veineux
US16/302,051 US10912938B2 (en) 2016-05-19 2017-05-04 Dual multipolar lead implantable in the coronary venous network
US17/170,424 US12042650B2 (en) 2016-05-19 2021-02-08 Dual multipolar lead implantable in the coronary venous network

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
FR1654463 2016-05-19
FR1654463 2016-05-19

Related Child Applications (2)

Application Number Title Priority Date Filing Date
US16/302,051 A-371-Of-International US10912938B2 (en) 2016-05-19 2017-05-04 Dual multipolar lead implantable in the coronary venous network
US17/170,424 Continuation US12042650B2 (en) 2016-05-19 2021-02-08 Dual multipolar lead implantable in the coronary venous network

Publications (1)

Publication Number Publication Date
WO2017198472A1 true WO2017198472A1 (fr) 2017-11-23

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PCT/EP2017/060661 Ceased WO2017198472A1 (fr) 2016-05-19 2017-05-04 Fil multipolaire double implantable dans le réseau coronarien veineux

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US (2) US10912938B2 (fr)
EP (1) EP3458148B1 (fr)
WO (1) WO2017198472A1 (fr)

Cited By (6)

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WO2022009100A3 (fr) * 2020-07-08 2022-02-24 AtaCor Medical, Inc. Fils électriques implantables et systèmes de mise en place associés
US11672975B2 (en) 2019-05-29 2023-06-13 AtaCor Medical, Inc. Implantable electrical leads and associated delivery systems
US11844949B2 (en) 2014-09-04 2023-12-19 AtaCor Medical, Inc. Cardiac defibrillation
US11857380B2 (en) 2014-09-04 2024-01-02 AtaCor Medical, Inc. Cardiac arrhythmia treatment devices and delivery
US11931586B2 (en) 2014-11-24 2024-03-19 AtaCor Medical, Inc. Cardiac pacing sensing and control
US12471896B2 (en) 2021-11-24 2025-11-18 AtaCor Medical, Inc. Systems and methods for lead delivery

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WO2025207976A1 (fr) * 2024-03-29 2025-10-02 The Alfred E. Mann Foundation For Scientific Research Systèmes médicaux implantables à dérivations médicales avec interfaces neuronales multiples

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EP2581107A1 (fr) 2011-10-14 2013-04-17 Sorin CRM SAS Microsonde de détection/stimulation, implantable dans des réseaux veineux, artériels ou lymphatiques
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US20190201686A1 (en) 2019-07-04
US10912938B2 (en) 2021-02-09
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US20210236813A1 (en) 2021-08-05
US12042650B2 (en) 2024-07-23
EP3458148A1 (fr) 2019-03-27

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